Individual
MRS. JACLYN CASTRONOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-6000
(781) 744-8000
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2311879
MA
363LF0000X
Family Nurse Practitioner
4175
SC
363LF0000X
Family Nurse Practitioner
8995618-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1740
—
SC
Enumeration date
07/27/2010
Last updated
09/22/2023
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